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, 14 (11), e0224499

Indirect Violence Exposure and Mental Health Symptoms Among an Urban Public-School Population: Prevalence and Correlates


Indirect Violence Exposure and Mental Health Symptoms Among an Urban Public-School Population: Prevalence and Correlates

Erica L Gollub et al. PLoS One.


Available literature identifies the need for a deeper understanding of the role of gender, age and socioeconomic status in children's exposure to violence and associations with mental health (MH) outcomes. The 1548 participants for this study were enrolled from 28 public charter schools and 9 community-based settings; youth were administered a screener that assessed exposure to traumatic events and symptoms of post-traumatic stress disorder (PTSD) and depression. Respondents reported extremely high levels of exposure to indirect violence: 41.7% witnessed shooting/stabbing/beating; 18.3% witnessed murder; and 53.8% experienced the murder of someone close. Frequency of adverse MH outcomes was high: 21.2% screened positive for depression; 45.7% for lifetime PTSD; and 26.9% for current PTSD. More males than females reported witnessing shooting/stabbing/beating (p = .04); females more often reported experiencing the murder of someone close (p = .001). Indirect violence exposure generally increased with age. Youth attending schools with ≥90% free/reduced lunch participation (FRLP) showed significantly higher levels of violence exposure compared to youth in schools with <90% FRLP. Females endorsed significantly higher levels of depression (21.4% vs. 9.7%), and lifetime (53.9% vs. 34.9%) and current (32.5% vs. 19.6%) PTSD, compared with males (p < .0001, all comparisons). Female sex (aOR = 2.6), FRLP (aOR = 1.4 for ≥90% vs. <90%) and the number of different indirect violence exposures (aORs from 1.3 to 10.4), were significantly associated with a positive screen for any adverse MH outcome. Our data add important insights into gender heterogeneity of viewed violence, mental health symptoms, and their association-all of which are critical to guiding effective intervention efforts.

Conflict of interest statement

The authors have declared that no competing interests exist.


Fig 1
Fig 1. Consort diagram of BY-LA emotional wellness screener (EWS) completion.
Fig 2
Fig 2. Symptomatology of depression and/or PTSD among males and females at age 11 and age 14.

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    1. Pabayo R, Molnar BE, Kawachi I. Witnessing a violent death and smoking, alcohol consumption, and marijuana use among adolescents. J Urban Health. 2014;91(2):335–54. Epub 2013/10/03. 10.1007/s11524-013-9828-5 - DOI - PMC - PubMed
    1. Finkelhor D, Turner H, Ormrod R, Hamby SL. Violence, abuse, and crime exposure in a national sample of children and youth. Pediatrics. 2009;124(5):1411–23. Epub 2009/10/07. 10.1542/peds.2009-0467 . - DOI - PubMed
    1. Hickman LJ, Jaycox LH, Setodji CM, Kofner A, Schultz D, Barnes-Proby D, et al. How much does "how much" matter? Assessing the relationship between children's lifetime exposure to violence and trauma symptoms, behavior problems, and parenting stress. J Interpers Violence. 2013;28(6):1338–62. Epub 2012/12/26. 10.1177/0886260512468239 . - DOI - PubMed
    1. Mrug S, Windle M. Prospective effects of violence exposure across multiple contexts on early adolescents' internalizing and externalizing problems. J Child Psychol Psychiatry. 2010;51(8):953–61. Epub 2010/03/25. 10.1111/j.1469-7610.2010.02222.x - DOI - PMC - PubMed
    1. Finkelhor D, Dziuba-Leatherman J. Children as victims of violence: A national survey. Pediatrics. 1994;94(4):413–20. 10.1016/0145-2134(94)00111-7 - DOI - PubMed

Grant support

This study was supported by contract #TP1AH000084-01-00 from the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Health, Office of Adolescent Health to the Institute of Women & Ethnic Studies. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.